显微血管减压术治疗偏头痛及预后分析

Microscopic nerve decompression for migraines and its prognostic analysis

目的探讨显微血管减压术治疗偏头痛患者术后影响预后的相关因素。方法随访2006年1月至2010年7月在我院接受显微血管减压术治疗的96例偏头痛患者，回顾性分析疼痛发作部位，范围以及术中病变特征与预后相关关系。结果随访1-4年（平均随访24．6个月），完全治愈73％，总有效率（治愈＋显效）91％，好转7％，无效2％，其中耳颞区域、眶额区域、后枕区域以及两个或两个以上复合区域治愈率和总有效率分别为58％、83％、88％、62％和90％、92％、96％、81％。提示耳颞及复合区域的根治效果低于其他区域。另外，术中发现神经受血管卡压较明显的病例，其减压效果较显著。结论显微血管减压手术方法是治疗偏头痛的一种有效的外科手段，而疼痛部位、疼痛范围以及不同病变特征与其预后密切相关。

Objective To explore the microscopic vascular decompression surgery for the prognosis in patients with migraine of related factors. Methods Attack, pain, scope and part intraoperative lesions characteristic and the prognosis were retrospectively analyzed in 96 cases of migraine patients witch accepted microscopic vascular decompression treatment from January 2006 to July 2010 in our hospital. Results 1 to 4 years of follow - up （ average follow - up of 24. 6 months） , and complete cure was 73% , total effective （cure ＋ efficient） was91% , improvement was 7% , 2% among them was invalid. The temporal ears,orbital frontal,after pillow and two or more than two composite regional cure rate and the total effective rate were 58%, 83%, 88%, 62% and 90%, 92%, 96%, 81%. Point out the temporal ears and composite region of the effect than other areas. In addition, intraoperative found the oppressed nerve by vascular more apparent cases, the reduced pressure effect is remarkable. Conclusion Microscopic vascular decompression surgery method for the treatment of migraine is an effective surgical methods, and painful place, pain in the range and different lesions characteristics is closely related with its prognosis.